Hygiene, Hand Washing, Clean Water and Sanitation

Safe drinking water is essential to good health. But in resource-poor settings, water often comes from
unsafe sources and carries deadly pathogens. Of the nearly two million deaths from diarrheal disease
each year, many are due to an unsafe water supply. PATH’s Safe Water Project is testing commercial market approaches for household water treatment and
safe storage products in Andhra Pradesh, India, learning about bridging the gap in the distribution
of products to developing-country poor. The project focuses on working with partners to build
distribution channels, improve existing products to make them more appropriate for low-income settings,
and learn about generating demand to sustain correct use and purchase decisions. Ultimately, the project
will provide strategies and tools for scale-up, replication, and sustainability for a range of
settings. Research on the water treatment market, products, and behaviors is also being conducted in
Vietnam, Cambodia, Ghana, Tanzania, and Kenya to support these strategies and tools. More information
is available on the PATH website.
UNICEF collaborates with partners, families, and communities in more than 90 countries to improve
water supply and sanitation, promote safe hygiene practices, and give urgent relief in response to
disrupted water supplies and waterborne diseases.

UNICEF: Syrian children sing their way to better health and
hygiene

Key resources

Below are some key documents on handwashing, clean water, and sanitation. Please also visit our partners’ websites for more resources.

Reproduced from the PATH Resources for Diarrheal Disease Control website at
www.eddcontrol.org, [6 November, 2009].

Why it is important to share and act on information about Hygiene More than half of all illnesses and deaths among young children are caused by germs that get into their mouths through food or water or dirty hands. Many of these germs come from human and animal faeces. Many illnesses, especially diarrhoea, can be prevented by good hygiene practices: putting all faeces in a toilet or latrine; washing hands with soap and water or ash and water after defecating or handling children's faeces, and before feeding children or touching food; and ensuring that animal faeces are kept away from the house, paths, wells and children's play areas. Everyone in the community needs to work together to build and use toilets and latrines, protect water sources, and safely dispose of waste water and garbage. It is important for governments to support communities by providing information on low-cost latrines and toilet facilities that all families can afford. In urban areas, government support is needed for low-cost sanitation and drainage systems, improved drinking water supply, and garbage collection.What every family and community has a right to know about Hygiene

Hygiene On-line Resources

Effect of washing hands with soap on diarrhoea risk in the
community: A systematic review (abstract only; 2003)
Through a systematic review, the authors found that washing hands with soap can reduce the risk of diarrheal diseases by up to 47 percent and
hand-washing promotion could save one million lives. The review also calls for more and better-designed trials to further measure the impact
of hand-washing on diarrhea and acute respiratory infections in developing countries.Curtis V, Cairncross S. Lancet. 3(5):275-281. Clean hands reduce the burden of disease (2005)
This commentary describes the complexities of hand-washing promotion among low-resource communities, in reference to a study conducted in
Pakistan that found a reduction in infectious disease incidence, including diarrheal episodes, through application of hand-hygiene
education and resources.
Pittet D. Lancet. 366(9841):185–186. pdf 365 kbThe handwashing handbook: A guide for developing a hygiene
promotion program to increase handwashing with soap (2005)
This guide was created for public health staff working to implement community hand-washing programs and decision-makers developing public
health policy on hygiene practices.World Bankpdf English 1.57 mbHealth, dignity and development: What will it take? (2005)
With respect to achieving the Millennium Development Goals, this report
focuses on the necessary steps and potential impact of expanding and
sustaining water supply and sanitation coverage
World Health Organization (WHO) Millennium Project Task Force on Water
and Sanitation pdf English 1.71 mb

General information

Global water supply and sanitation assessment report (2000)
The report provides a global overview of water supply and sanitation.
WHO and UNICEF Joint Monitoring Programme for Water Supply and SanitationHealth in Your Hands: The global public-private partnership
for handwashing with soap
This collaboration of international organizations promotes handwashing with soap as an intervention to reduce the incidence of diarrheal
disease in poor communities. Resources on this website include lessons learned, behavior studies, public service announcements, and much more.Water Supply and Sanitation DivisionWorld Bank This website provides information about World Bank activities addressing water and sanitation strategy and policies. Activities are categorized by topic and/or region.Water Supply, Sanitation and Hygiene DevelopmentDivision
This division of WHO performs activities and provides guidance toward sanitation improvement and enhanced hygiene practices.WHO Water and health in Mali (2006)
This case study from the UN’s World Water Development Report 2006 provides an overview of health challenges faced by a lack of clean water
in poor communities in Mali and outlines efforts to address them.United Nations (UN) pdf English 251 Kb

Research

Evaluation of the costs and benefits of water and sanitation
at the global level (2004)
The aim of this study was to estimate the economic costs and benefits of selected interventions toward water and sanitation improvement. The
document presents both regional and global analyses.WHOA randomized, controlled trial of a multifaceted intervention
including alcohol-based hand sanitizer and hand-hygiene education to
reduce illness transmission in the home (abstract only; 2005)
This study analyzed the use of hand sanitizer and hygiene education among families who have at least one child enrolled in out-of-home care
and found that transmission of illness was reduced when interventions with alcohol-based sanitizer and multifaceted education messages were introduced.
Sandora T, et al. Pediatrics. 116(3):587–594.Effect of Intensive Handwashing Promotion on Childhood
Diarrhea in High-Risk Communities in Pakistan (2004)
This study implemented handwashing interventions with plain and antibacterial soap and found that diarrhea incidence was reduced among
children of ages ranging from infancy to 15 years.
Luby S, Agboatwalla M, Painter J, Altaf A, Billhimer W, Hoekstra R. Journal of the American Medical Association; 291(21):2547–2554.Handwashing-related research findings (1998)
This summary provides statistics on hand-washing practices in the US, as reported and observed through the Handwashing Observational and
Telephone Survey conducted for the Bayer Corporation Pharmaceutical Division in association with the American Society for Microbiology.
US Food and Drug AdministrationWater, sanitation and hygiene: Interventions and diarrhoea - A systematic review and meta-analysis (2004)
This paper offers a review of studies in developing countries, as well as in established market economies, that assessed the public health
impact of specific interventions in water quality, water supply, hygiene, and sanitation.
Fewtrell L, Colford J. World Bank pdf English 1 mbReported measures of hygiene and incidence rates for hospital-acquired diarrhea in 31 French pediatric wards: Is there any
relationship? (2003)
This study evaluated simple hygienic measures for reducing hospital-acquired diarrhea.
Jusot J, Vanhems P, Benzait F, et al. Infection Control and Hospital Epidemiology. 24(7):520–525. pdf English 136 kb